Reversible freezing of gait caused by dural arteriovenous fistula and congestion of the globus pallidus


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Freezing of gait (FOG) is defined as an episodic inability to generate effective stepping in the absence of any known cause other than parkinsonism or high-level gait disorders.


We present a 59-year-old male with acute, progressive episodes of FOG. Imaging studies revealed a dural arteriovenous fistula (DAVF) associated with edema of the globus pallidus interna (GPi). Cerebral angiography confirmed the diagnosis of DAVF and demonstrated an occluded straight sinus and a retrograde blood flow of deep cerebral veins.


After endovascular closure of the DAVF, a major improvement of FOG was observed concomitant with striking near resolution of GPi congestion.


This reversal of the clinical course, correlated with changes in imaging studies, suggests a major role of the GPi in the pathology of FOG. © 2012 Movement Disorder Society